Individual
MRS. BERNADETTE CELESTE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5732 ROSEBURY DR, HUBER HEIGHTS, OH 45424-4352
(937) 236-1931
(937) 236-1931
Mailing address
5732 ROSEBURY DR, HUBER HEIGHTS, OH 45424-4352
(937) 236-1931
(937) 236-1931
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN112254
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2410975
—
OH
Enumeration date
06/05/2007
Last updated
07/09/2007
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